Services

'Reform the NHS or see it go bust'

A radical shift in the culture of the NHS is needed to rid it of outdated working practices, cure it of widespread bullying and heal the damaging rift between managers and clinicians, the head of its official regulator has warned.

David Prior, chairman of the Care Quality Commission (CQC), also called for serious "transformational change" of the health service, without which it will "go bust".

Writing in the Sunday Telegraph, Mr Prior called for greater input from the private sector, the merging of hospitals and changes to the way the NHS is held to account - particularly, the scrapping of waiting targets.

He highlighted the "alarming" revelation that a survey of 100,000 NHS staff found one in four had been bullied. He also described the NHS as having a culture that "stigmatises and ostracises" whistleblowers who raise concerns or complaints.

His warning comes at a time when the NHS is struggling to emerge from crises such as the Mid-Staffs scandal, where hundreds of patients died and suffered neglect, as well as facing rising costs and an ageing population.

Mr Prior, a former MP and deputy chairman of the Conservative Party, who was appointed to run the CQC last year, said: "Too often it (the NHS) delights in the ritual humiliation of those deemed to fail, tolerates and institutionalises outdated working practices and old-fashioned hierarchies, and can almost encourage 'managers' and 'clinicians' to occupy opposing camps.

"I have worked in the NHS for 12 years. I love it - I am often overwhelmed by the kindness, care and skills of its staff - and yet am too often shocked by some of the behaviour I see."

He also described a "them and us" relationship between hospital managers and clinicians, a dangerous rift he said needed "radically altering" to avoid jeopardising patients' safety and blocking care improvements.

Mr Prior called for a major restructuring in healthcare provision, with more successful hospitals taking over failing ones, shared services, improved community services and better care outside hospitals.

More competition - with more entrants into the market from private sector companies, the voluntary sector and other care providers - is needed to drive up standards, and measures of hospital performance need to change, he said.

"We need the Government to change the way it holds the NHS to account: an end to trusts being blindsided by waiting targets that miss the point, skew priorities and have unintended consequences."

A Department of Health spokesman said: "Significant changes to the NHS are already under way - and we're seeing results, with increases in productivity for the first time in a decade, even at a time of rising demand.

"We have given doctors the power to make decisions about who should provide care for their patients, and this government is investing £3.8 billion to join up health and social care.

"Poor care is now being addressed like never before.

"We are turning around 14 hospitals where failure was previously tolerated.

"We have taken swift and strong action to create an NHS culture of transparency and openness where staff and patients are free to raise concerns.

"Whistleblowers are now better protected and cannot be ignored.

"The CQC is helping to drive this culture change through rigorous, independent inspections under three powerful new chief inspectors."

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